amfAR, The Foundation for AIDS Research

Women and Girls Face Unique HIV Challenges

March 10 is National Women and Girls HIV/AIDS Awareness Day

Today in the United States, women and girls account for almost one in five new HIV diagnoses. About one in four people living with HIV in the U.S. are women, and approximately one in eight women living with HIV don't know they are infected. Women are also more likely than men to contract HIV through heterosexual contact; the majority of women (87%) become infected this way.1,2

While treatment and prevention efforts aimed at women have started to improve in recent years, women remain underrepresented in many HIV-related clinical trials. This presents a major challenge for researchers aiming to develop more effective HIV interventions for women.

“The National Institutes of Health has called for more clinical trials to study HIV in women to understand how research impacts women,” said Dr. Sulggi Lee, Assistant Professor of Medicine at the University of California, San Francisco, and a researcher at the amfAR Institute for HIV Cure Research. “It’s important to be able to study all genders and races. Otherwise you’re applying a one-size-fits-all approach to a population that’s very heterogeneous, and the conclusions reached may not be accurate for everyone.”

Dr. Sulggi Lee speaking at the amfAR Cure Summit, University of California, San Francisco, November 2018 
Dr. Sulggi Lee speaking at the amfAR Cure Summit, University of California, San Francisco, November 2018

“In San Francisco where I work, for example, we have a much harder time recruiting premenopausal women of African American or Latina ethnicity, compared with gay white men,” said Dr. Lee. “How do you recruit enough to make conclusions? It’s a balance not just for HIV research, but in general for scientific research. We need to establish research sites that are convenient for people of the populations we’d like to study. I also think that if we have more studies making gender-based discoveries, it will have a snowball effect and then more women and minorities will want to participate.”

HIV diagnoses fell 16% among all women from 2011 to 2015, including a 20% decrease among African American women and a 14% decrease among Latina women.1 Yet large disparities remain: HIV diagnoses among African-American women are 16 times higher than among white women, and Latinas are three times more likely to receive an HIV diagnosis than white women.3  

On the prevention front, a number of advocates are pushing to make more African American women aware of pre-exposure prophylaxis (PrEP). A report from National Public Radio says that although a group of 50 experts in HIV and women’s health urged public health agencies to promote PrEP explicitly to women in 2013, this has not been done on any significant scale. The article describes recent efforts now under way in some hard-hit communities including Atlanta, Georgia, to increase knowledge about PrEP among women black women.

For more information and resources, see https://www.hiv.gov/events/awareness-days/women-and-girls

1 U.S. Centers for Disease Control and Prevention: HIV Among Women, July 2018
2 U.S. Department of Health and Human Services, Office on Women's Health: Women and HIV
3 The Well Project: Women and HIV, February 2019